Organization Active NPI

Complete Vision Care, PLLC

  • Optometrist
  • Ponca City, OK
National Provider Identifier
1134384241
Registry record updated Aug 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2588 Issued in OK
Legal business name
COMPLETE VISION CARE, PLLC
Practice address
521 E Hartford Ave
Ponca City, OK 74601-2004
Phone
(580) 765-3379
Fax
(580) 765-6323
NPI assigned
Jul 29, 2008
Last updated
Aug 11, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Brian Zwanziger, O.D.NPI 1871758045
Title
President
Phone
(580) 765-3379

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2588 OK Primary

Addresses

Primary practice location

521 E Hartford Ave
Ponca City, OK 74601-2004

Mailing address

521 E Hartford Ave
Ponca City, OK 74601-2004
Phone (580) 765-3379

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20081117000505 OK Part B Supplier - Clinic/Group Practice 6305906611 Receives reassigned benefits from 2 practitioners
Practice locations: Ponca City, OK
O20100930081375 OK DME Supplier - Physician - Optometrist 6305906611 Practice locations: Ponca City, OK

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Complete Vision Care, PLLC521 E Hartford Ave, Ponca City, OK 74601-2004(580) 765-3379 Prosthetic Lenses: Conventional Eyeglasses Accepts assignmentParticipating since Oct 1, 2008

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1217289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1249948800000",
    "number": "1134384241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 E HARTFORD AVE",
            "city": "PONCA CITY",
            "state": "OK",
            "postal_code": "746012004",
            "telephone_number": "580-765-3379",
            "fax_number": "580-765-6323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 E HARTFORD AVE",
            "city": "PONCA CITY",
            "state": "OK",
            "postal_code": "746012004",
            "telephone_number": "580-765-3379",
            "fax_number": "580-765-6323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPLETE VISION CARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-29",
        "last_updated": "2009-08-11",
        "status": "A",
        "authorized_official_last_name": "ZWANZIGER",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "580-765-3379",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "2588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponca City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.